This is The BREAST CANCER 101 Section. It is divided into six sections. Please click on menu below for area of interest.

Introduction to Breast Cancer: Breast Cancer by Type

When first diagnosed, it is important to remember that breast cancer is not just one type of cancer. No two types are the same and no two women are the same. You cannot compare your diagnosis to someone else's prognosis. Just because two women have the same disease does not mean that their outcome will be the same.

It is vital that you learn as much as you can about your particular cancer. The more you know, the better patient you are because you become a partner in your health care decisions with your doctor. Don't be afraid to ask questions, and don't leave until you are satisfied with the answers you get.

Ductal Cancer In Situ

Ductal Carcinoma In Situ (DCIS) is cancer at its beginning. The cells have mutated and divided and begun to proliferate but they have remained inside the milk duct.

DCIS is sometimes called a pre-cancer. It can often be cured with a mastectomy alone. Some women have DCIS in only one quadrant of the breast, “multi-focal”, and can have a lumpectomy and radiation. Others have it in more than one quadrant, “multi-centric” and then the only choice is mastectomy.

Now that women are getting their mammograms earlier and more regularly, they are getting their cancers diagnosed at the earliest stage possible. The more this happens, the closer we are to saving women from the more advanced invasive or infiltrating cancers. The rate of DCIS has not increased but the number of women who have found their cancer while it was still small has. That is why early detection is so very important.


Lobular Carcinoma In Situ

Lobular Carcinoma In Situ (LCIS) is cancer that is confined to the milk lobule. The cells could sit dormant for a woman’s lifetime, because of this it also referred to as a “neoplasm” or pre- malignancy.

This makes treating it a challenge. Unlike Ductal Cancer In Situ, a diagnosis of LCIS means that you have other treatment choices that range from close watching to prophylactic mastectomy. This is one for you and your physician to thoroughly investigate.

Infiltrating or Invasive Ductal Carcinoma (IDC)

Infiltrating or Invasive Ductal Carcinoma (IDC) makes up the majority of breast cancers being diagnosed. It is a cancer that has broken through the milk duct membrane and grown to become a lump or tumor and is now invading or infiltrating healthy breast tissue.

When a pathologist examines it later, he will be able to measure how fast it grew and how aggressive it was by how many of the cells are dead, (necrosis), how many new cells are created (mitosis) and what role the DNA played in this cycle. From this information you and your doctor can decide on what treatment plan is best for you.


Infiltrating or Invasive Lobular Carcinoma (ILC)

Less than 15% of breast cancers originate in the milk lobule. This means that it occurs in the actual lobules that produce milk. Infiltrating Lobular Carcinoma (ILC) is a lobular cancer that has broken outside of the lobule. ILC has a propensity to occur not only in the opposite breast, but in other quadrants of the same breast.

Invasive lobular is hard to detect because rather than forming a lump it grows in what has been described as sheets or leaves. If you imagine a branch of a tree and the leaves filling out and growing, that is essentially how lobular cancer appears when it is spreading.

Because it is harder to detect that ductal cancer, lobular cancer is often larger when discovered. By its nature, however, lobular is not as aggressive as ductal cancer, so the size does not effect the prognosis as much as a ductal cancer would be found the at same size.

Inflammatory Breast Cancer

Tremendous strides have been made and there has been a dramatic change in the prognosis of IBC.

Inflammatory breast cancer is a very aggressive form of breast cancer. It presents itself with swelling, a feeling of heat inside the skin, a red tinge to the breast area and the breast sometimes swells up too. In some cases dark red or purple stripes may appear across the chest. The skin may pucker inwards like the skin of an orange. At first glance a doctor would view a swollen, hot breast with a rash and declare mastitis, which is a breast infection. Antibiotics are given and nothing helps. Sometimes it may take several visits to the doctor or even a change in doctors before the possibility of IBC is investigated.

Once the diagnosis is made, the key is to act fast. The treatment for IBC is not the same as for regular breast cancer. The protocol has changed to make the treatment of IBC much more successful.


Paget’s Disease

Paget’s disease is sometimes cancerous, but not always. When it is cancer, it is a type of in situ cancer that can begin in the ducts of the nipple. It grows close to the skin or the nipple and then can appear like IBC does with the swelling, heat and the orange peel skin. There may also be an itchy rash and a bloody discharge from the nipple. The nipple will also become inverted.

The type of cancer that lies beneath the skin will determine the treatment. Hormonal therapy will be given if appropriate following surgery, chemotherapy and radiation.

Medullary carcinoma

Medullary cancer is a cancer with the best prognosis of all. It is clearly identifiable and not as aggressive as the other breast cancers. Only a very small percent of women are diagnosed with Medullary cancer. However, women who carry the breast cancer gene mutation, BRCA 1, have a greater chance of developing Medullary cancer.

Generally, the prognosis for patients with medullary carcinoma is better than for women with other types of invasive ductal or lobular carcinoma.

Phyllodes

A phyllodes tumor can be found in the breast tissue that surrounds the ducts and lobules. Most often they are not cancerous. However, if they are, they do not respond to the traditional therapy that is effective on ductal or lobular cancers. The treatment consists of surgery, either by lumpectomy

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